Individual
YOLANDE COLLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2724 CONCH HOLLOW DR, BRANDON, FL 33511-7348
(201) 478-1688
Mailing address
2724 CONCH HOLLOW DR, BRANDON, FL 33511-7348
(201) 478-1688
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
5751-3-FA
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024700900
—
FL
Enumeration date
01/26/2022
Last updated
01/26/2022
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